Ekenesenarienrien Cynthia Omokaro, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

D86562 Issued in MD

Practice address

1221 Mercantile LN
Upper Marlboro, MD 20774-5374

Phone

(518) 380-8859

NPI assigned

May 2, 2014

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MN, DC2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Emergency Medicine

Education

Albany Medical College of Union University, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kaiser Foundation Health Plan of the Mid Atlantic States, IncGroup PAC ID 3779495858, 1,921 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  dba Kaiser Permanente Annapolis Medical Center

  • Health Maintenance Organization
  • Annapolis, MD
  • NPI 1952461816

  DC, Family Medicine

  Medicare reassignment Care Compare group NPD
• Altru Health System

  dba Altru Clinic Crookston

  • Clinic/Center
  • Crookston, MN
  • NPI 1760494330
  Medicare reassignment NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  dba Kaiser Permanente Gaithersburg Medical Center

  • Health Maintenance Organization
  • Gaithersburg, MD
  • NPI 1831471713
  NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  dba Kaiser Permanente Shady Grove Peritoneal Dialysis Facility

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Rockville, MD
  • NPI 1962108753
  NPD
• Altru Health System

  dba Altru Care Flight

  • Ambulance
  • Grand Forks, ND
  • NPI 1114485315
  NPD
• Altru Health System

  dba Altru Clinic - Thief River Falls

  • Rural Health Clinic/Center
  • Thief River Falls, MN
  • NPI 1285074328
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1398988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624060800000",
    "number": "1992115737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10509 LOUISVILLE LN",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207746048",
            "telephone_number": "518-380-8859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 MERCANTILE LN",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207745374",
            "telephone_number": "518-380-8859"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9000 Franklin Square Dr",
            "address_2": "Department of Family Medicine",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212373901",
            "country_code": "US",
            "telephone_number": "443-777-2000",
            "fax_number": "443-777-2034",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Essentia Health Fosston Clinic",
            "address_2": "900 Hilligoss Blvd. SE",
            "address_purpose": "LOCATION",
            "city": "Fosston",
            "state": "MN",
            "postal_code": "56542",
            "country_code": "US",
            "telephone_number": "218-435-1133",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OMOKARO",
        "first_name": "EKENESENARIENRIEN",
        "middle_name": "CYNTHIA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-02",
        "last_updated": "2021-06-19",
        "certification_date": "2021-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "62923",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D86562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1221 Mercantile Ln",
            "city": "Upper Marlboro",
            "state": "MD",
            "country_code": "US",
            "postal_code": "207745374",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Nwamaka Olutola Oluwato, M.D.
• Omnipresence Healthcare Agency LLC
• Ejobe Omo-Taiga
• Bamidele Omobo
• Foluke Titilayo Omobo, CRNP-PMH
• Ismaila Adetunji Omolabi
• Linda Omole
• On the Go Transportation, Inc.
• Adepeju Rukayat Onabiyi, HHA
• Joy I Onaghise, MD

• Family Medicine Physician in Upper Marlboro, MD
• Providers in Upper Marlboro, MD by specialty
• Family Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.